P1386: A REVIEW OF HEMATOPOIETIC CELL TRANSPLANTATION IN TAIWAN: DATA AND TRENDS DURING 2009–2018
Authors: Y.-H. Wang, S.-P. Yeh, J.-P. Gau, P.-N. Wang, Y.-C. Liu, Y.-C. Chen, C.-L. J. Teng, T.-Y. Chen, S.-C. Lin, T.-D. Tan, T.-F. Wang, M.-C. Ma, S.-J. Lin, C. Wang, M.-Y. Lee, C.-C. Chen, T.-Y. Chao, S.-T. Jou, M. Yao, B.-S. Ko
Journal: HemaSphere (2022)

Background: Despite the advent of novel gents and CAR-T therapies, haematopoietic cell transplantation (HCT) remains the curative treatment for many malignant and non-malignant diseases involving the hematopoietic system and some solid tumours. Aims: To decipher the patient and donor pools in Taiwan and provide valuable information for clinicians, investigators, and patients worldwide, we performed this cross-sectional survey, which adopted a standardized registry structure, to present and discuss trends and outcomes of HCTs in Taiwan during 2009-2018. Methods: Currently, 17 hospitals contribute to the registry, and the collection and analysis of data from the Taiwan Blood and Marrow Transplantation Registry is approved by the institutional review board of each participating hospital. All methods were carried out in accordance with relevant guidelines and regulations. Patient numbers corresponding to the number of patients receiving their first HCTs between 2009 and 2018 and transplant numbers reflecting the total number of transplants performed are presented. Haploidentical transplants are being described as any family member with two or more (but not more than 5) loci mismatches. Results: The record number of HCTs was 4927 HCT in 4738 patients, comprising 2688 (54.6%) allogeneic and 2239 (45.4%) autologous, reported by 17 centres. The main indications were lymphoid malignancies 3038 (64.1%), myeloid malignancies 1675 (35.4%), and non-malignant disorders 258 (5.4%). HCT trends showed growth in transplant activity, a rapid increase in the number of autologous HCT, remarkable growth in older (>60-year-old) patients receiving HCT, an increase in haploidentical donors (HID), and an expansion of harvesting stem cells from both the peripheral blood (PB) and the bone marrow (BM). HCTs have been implemented increasingly and most frequently for acute myeloid leukaemia, non-Hodgkin lymphomas, and multiple myeloma (MM). Amongst them, MM showed a particularly noticeable expansion in the number of HCT, comprising 15.7% in 2009 and 19.4% in 2018, respectively. The proportion of older patients receiving HCT, autologous and allogeneic, increased from 5.5% and 1.7% in 2009 to 17.7% and 10.5% in 2018, respectively. During this period, the proportion of autologous HCT rose from 44.3% in 2009 to 52.9% in 2018. Meanwhile, HID also showed a magnificent increase, accounting for 0.9% in 2009 and 6.5% in 2018, respectively. On the other hand, stem cells harvested from PB+BM increased from 0.3% in 2009 to 2.9% in 2018, while the use of PB stem cells remained stable during this time frame, spanning from 92% to 98%. Image:Summary/Conclusion: Aside from the significant elaboration of HCT technology, most worthy of mention developments include the success in haploidentical HCT and the use of reduced-intensity conditioning in older patients. Overall, this review of the TBMTR provides a snapshot of the current transplant state and highlights important HCT trends in Taiwan.